OT strategies and education help Betty manage safely at home and stay connected to the community

People who know Betty would probably say she is active and outgoing – someone who enjoys getting in her car to visit friends and family, go shopping, or drop by the seniors’ centre in her community. But over the past year friends and family worried that Betty, who is 78 years old, wasn’t getting out as much.

Betty wanted to be out and in touch with friends but she was feeling more and more nervous about leaving her home. She felt less steady on her feet and had a few falls. She slipped getting out of the bathtub and sprained her wrist, making other things like driving harder to do. Without realizing it Betty became isolated, rarely leaving her home. When Betty fell down the stairs in her house her family became very worried about her safety. They considered a senior residence for her, but knew she would rather stay in her own home.

An OT worked with Betty and her daughter to create a plan that would make it possible for her to live safely at home. She looked at the setup of Betty’s bungalow and checked her abilities and risks by watching her do everyday tasks, such as bathing, toileting, making her bed, cooking and light housekeeping. The OT also spent time talking to Betty about her goals and her understanding of her situation. Based on this thorough research and consultation with Betty and her daughter, the OT made a number of suggestions that would help Betty live comfortably and safely in her own home. This plan included:

• Identifying tasks that Betty should ask others to do – such as heavy housekeeping, shoveling snow, and moving things up and down the stairs – and letting Betty know about community resources that could help her
• Installing grab bars by the toilet and bathtub
• Moving the laundry room to the main level of her home
• Talking about ways to reduce her risk for falls
• Encouraging Betty to get out and take part in social activities, providing community transit options and setting up a driver evaluation so Betty could drive again
• A referral for a physiotherapy strengthening program.

By the time Betty finished her OT plan, she was feeling much more confident in her home – and in her ability to once again be an active part of her community. Today, in addition to enjoying the comforts of her safer and more accessible home, Betty is out and about in the community, working as a volunteer visitor for frail seniors. Her family is relieved and delighted to see Betty so active again.

Individual Education Plan helps James make the grade

School had become tough for James. The Grade 3 student couldn’t seem to finish his written work on time and did not do well in gym activities. He also had trouble tying his shoelaces and using a knife and fork.

James was referred to an OT, who started by studying his skills. The OT found James had problems with printing, forming letters and using lines, and noticed in gym class that he had poor coordination and ball skills. A psychoeducational test suggested by the OT found that James had a learning disability in writing.

The OT worked with James’ mother and special education teacher to revise James’ Individual Education Plan (IEP) to include providing extra time for writing tasks, a scribe who could support him during EQAO tests (province-wide testing), keyboard training, and access to a laptop.

As a result of the OT’s work, James got better at doing tasks at school and at home. He got EQAO scores at his grade level, learned to tie not only his shoelaces but also his belt for karate, and could easily use a knife and fork at the table. The OT also helped James’ father. After attending a parent education night on coordination challenges, he understood why his son could not throw a Frisbee straight. He became less frustrated now that he had the knowledge and tools to help James.

“So many good things have come from him having an Individual Education Plan,” James’ mother wrote the OT. “Thank you so much for helping my son.”

OT strategies transform a kindergarten student, and his entire class

Cody’s poor fine motor skills, problems working with a group, and sensitivity to loud noises were making it hard for him to learn in school – and creating problems for the rest of his kindergarten class. His teacher noted that Cody held his pencil with a fisted grip and could not cut with scissors. He walked around the classroom during lesson time, covered his ears during the morning announcements, and became upset when there was a fire drill.

To help Cody, an OT worked with the teacher to find ways to improve his fine motor skills and classroom participation, and reducing noises. They taught him different hand-strengthening activities and provided vertical surfaces for drawing and small broken crayons to develop his pencil grip. They also gave him loop scissors to make cutting easier.

The OT suggested a visual schedule to help Cody follow the classroom routine. At circle time, round vinyl placemats were used with the whole class so that each student knew where their seats were and to teach respect for personal space. To help Cody sit for the entire circle time, each session began with a quick movement activity. Tennis balls were put on chair legs to reduce noise and a retreat spot was set up where Cody could go if he needed time to “chill out.” In case noise levels got too high, protective earmuffs were made available to all students.

The result? Cody seems much happier now than he was at the start of the school year, reports his teacher. At the same time, she says, the OT’s plan for Cody has also helped other students in the class.

The outcome of these OT interventions? Cody seems much happier now than he was at the start of the school year, reports his teacher. At the same time, she says, the other students in the class have also benefited from these strategies.

OT takes Sarah’s writing from hard-to-read to clear and well organized

Eight-year-old Sarah was familiar with the alphabet. But the Grade 2 student’s printing was messy with letter formation and sizes that were all over the place. She also had problems maintaining attention and coordination. As a result, she was not finishing her school work on time.

An OT assessed Sarah and found she had problems with motor planning – that is, she found it hard to understand, organize, and perform actions in a certain order. To fix this problem, the OT created a cursive writing program based on a developmental structured approach and order.

Working with Sarah’s parents and teacher the OT applied the program, which included putting visual cues on a page and getting Sarah to say aloud the letter or word she was writing. The teacher used the program with the whole class and spent 15 minutes each day teaching students how to form letters and words. Sarah agreed to practise at home as well.

As she followed the program, Sarah learned to write her name, spell out words, and got better at organizing her work on the page. She learned to control letter sizes and her writing became clearer and less messy. Sarah felt proud when her teacher asked her to write the letter of the day on the blackboard. She was able to complete shorter assignments in her workbook on time. For other tasks she was able to use the classroom computer. Now she can read her handwriting and get her work done on time.

OT and assistive technology make school safer and easier for a child with cerebral palsy

Nathaniel is a 10-year-old boy with cerebral palsy. His parents and school staff were worried about his ability to move safely and independently within the school and take part in school activities. Because of his poor fine motor skills, Nathaniel wrote slowly, in a handwriting that was often hard to read.

An OT worked with Nathaniel, his parents and school staff to come up with ways to help him stay safe and independent in school, and enable him to do the school work. A supportive chair was suggested so he could sit at a regular desk in the classroom with his peers. The door of the accessible bathroom was adjusted so Nathaniel could open and close the door himself, and a supportive frame was put on the toilet for safety. The OT also helped Nathaniel develop his typing skills and taught him how to use assistive software.

Thanks to these changes, Nathaniel is able to manage better at school and keep up with the schoolwork.